CAC Fall 2019 Registration Form
Please add our email address to your contact list to avoid emails going to your spam folder.  Registration confirmations and pertinent class information will be sent via email from the following address: cac@towson.edu

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Student's First Name *
Student's Last Name *
Date of Birth *
MM
/
DD
/
YYYY
Student's Age *
(if under 18)
Grade/School *
Parent/Guardian Name *
Email Address *
Re-enter Email Address *
Best Contact Number *
Alternate Contact Number
Mailing Address *
City *
State *
Zipcode *
Emergency Contact Name and Number *
Will only call if parent/guardian can not be reached in an emergency  
I give permission for the Community Art Center to use my/my child's photograph in CAC marketing ads: *
Describe any relevant conditions that may affect your/your child's participation in the Community Art Center: *
(Please include any allergies or health concerns that we should be aware of)
How did you hear about us? *
Choose all that apply
Required
If "other," please specify:
1st Class Choice *
2nd Class Choice (if 1st choice is full) *
Towson University Faculty/Staff Members
Enter TU email to receive 10% employee discount
Payment Method *
Checks need to be received within 5 business days to ensure your reservation in the class.  Details for sending in a check will appear on the next screen.
I understand there is a $25 cancellation fee *
Digital Signature
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